201503734 - Laserfiche WebLink

Browse

ANCING STATEMENT ■TRUCTIONS HONE OF CONTACT AT FILER (optional) (800) 331-3282 Fax: (818) 662 -4141 — )NTACT AT FILER (optional) 'LS_Glendale_Customer Service @wolterskluwer.com OR lc. OR 2c. OR 3c. (NOWLEDGMENT TO: (Name and Address) 25677 - Citizens State )n Solutions cox 29071 Glendale, CA 91209 -9071 6500 SW Archer Rd Ste H — 4. COLLATERAL: This financing statement covers the following collateral: HVAC 7. ALTERNATIVE DESIGNATION (if applicable): ❑ Lessee/Lessor 8. OPTIONAL FILER REFERENCE DATA: 48328571 1175903 m m rr IA 48328571 - 1 NENE FIXTURE 1 ❑ Public- Finance Transaction ❑ Manufactured -Home Transaction ❑ A Debtor is a Transmitting Utility ❑ Consignee /Consignor FIUNG OFFICE COPY — UCC FINANCING STATEMENT (Form UCC1) (Rev. 04/20/11) n n 2A 7 ❑ Seller /Buyer rn rte) -z-1 _ r c' r i 0 0 F-_ cal CJ1 :n ::::, cDC/) CO Z7 cr.) x -JC CO "� _c4 6 o THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY to File with: Hall County Register of Deeds, NE 1. DEBTOR'S NAME: Provide only one Debtor name (la or 1b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name); if any part of the Individual Debtor's name will not fit in line lb, leave aU of item 1 blank, check here ❑ and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCCIAd) 1a. ORGANIZATION'S NAME 1b. INDIVIDUAL'S SURNAME WHITE MAILING ADDRESS FIRST PERSONAL NAME TOBY CITY ADDITIONAL NAME(S)/INITIAL(S) STATE POSTAL CODE SUFFIX COUNTRY 2311 N HOWARD AVE GRAND ISLAND NE 68803 USA 2. DEBTOR'S NAME: Provide only one Debtor name (2a or 2b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name); if any part of the Individual Debtor's name will not fit in line 2b, leave all of item 2 blank, check here ❑ and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) 2a. ORGANIZATIONS NAME 2b. INDIVIDUAL'S SURNAME MAILING ADDRESS FIRST PERSONAL NAME CITY ADDITIONAL NAME(S)INITIAL(S) STATE POSTAL CODE 3. SECURED PARTY'S NAME (or NAME of ASSIGNEE of ASSIGNOR SECURED PARTY): Provide only one Secured Party name (3a or 3b) SUFFIX COUNTRY 3a. ORGANIZATION'S NAME Citizens State Bank 3b. INDIVIDUALS SURNAME MAILING ADDRESS FIRST PERSONAL NAME Cm Gainesville ADDITIONAL NAME(SyINITIAL(S) STATE FL POSTAL CODE 32608 SUFFIX COUNTRY USA 5. Check 2L1k if applicable and check alione box: Collateral is ❑held in a Trust (see UCC1Ad, item 17 and Instructions) ❑being administered by a Decedent's Personal Representative 6a. Check ort if applicable and check or_Lk one box: 6b. Check ori_N if applicable and check any one box: ❑ Agricultural Lien ❑ Non -UCC Filing ❑ Bailee/Bailor ❑ Licensee/Licensor Prepared by CT Uen Solutions, P.O. Box 29071, Glendale, CA 91209 -9071 Tel (800) 331 -3282